STIM

Image source: The Motley Fool. Tuesday, Aug. 11, 2026 at 8:30 a.m. ET President and Chief Executive Officer - Dan Reuvers Chief Financial Officer - Nir Naor ICR Healthcare - Mike Vallie Operator: Good day and thank you for standing by. Welcome to the Neuronetics Second Quarter 2026 Financial and Operating Results Conference Call. [Operator Instructions] Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Mike Vallie from ICR Healthcare. Please go ahead. Unknown Attendee: Good morning and thank you for joining us for the Neuronetics second quarter 2026 conference call. Joining me on today's call are the Neuronetics President and Chief Executive Officer, Dan Reuvers, and the company's recently appointed Chief Financial Officer, Nir Naor. Before we begin, I would like to caution listeners that certain information discussed by management during this conference call will include forward-looking statements covered under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, including statements related to our business, strategy, financial and revenue guidance, and other operational issues and metrics. Actual results can differ materially from those stated or implied by these forward-looking statements due to risks and uncertainties associated with the company's business. For discussion of risks and uncertainties associated with Neuronetics' business, I encourage you to review the company's filings with the Securities and Exchange Commission, including the company's annual report on Form 10-K, which was filed in March, and the company's quarterly report on Form 10-Q for the quarter ending June 30, 2026. The company disclaims any obligation to update any forward-looking statements made during the course of this call except as required by law. During the call, we'll also discuss certain information on a non-GAAP basis, including EBITDA. Management believes that non-GAAP financial information taken in conjunction with U.S. GAAP financial measures provides useful information for both management and investors by excluding certain non-cash and other expenses that are not indicative of trends in our operating results. Reconciliations between U.S. GAAP and non-GAAP results are presented in the tables accompanying our press release, which can be viewed on our website. With that, it's my pleasure to turn the call over to Neuronetics President and Chief Executive Officer, Dan Reuvers. Daniel Reuvers: Thanks, Mike, and good morning, everyone. Thank you for joining us. I'll walk you through the quarter and each side of the business, and then I'll turn it to Nir to cover the financials in greater detail. Then I'll come back with how we're thinking about the rest of the year before opening it up for questions. Having now spent several months in the role, meeting with customers, spending time in our clinics and working alongside our field team, I've gained a clearer view of where the business is performing and where opportunities exist. I'm pleased to report the second quarter began to reflect our steady execution against the goals I cited last quarter. Total revenue was $41.6 million, up approximately 9% versus the second quarter of last year. The results reflect the continued strength of Greenbrook and some early impacts of our NeuroStar TMS go-to-market pilot. Importantly, we began to show meaningful progress towards profitability and reduced our cash burn significantly. Starting with NeuroStar, total worldwide NeuroStar revenue was $14.7 million. On the capital side, we had a strong quarter. This reflected an encouraging early reception to our second quarter go-to-market pilot, including a deliberate change in how we compete for customers. For most of our history, we offered essentially 1 way to work with us, a treatment session model built around a high-touch partnership between Neuronetics and our customer. It's a model we believe in and 1 that continues to set us apart, with NeuroStar customers performing almost twice as many treatments per chair as the competitive landscape. A velocity improvement that directly reflects our unparalleled support. But as the TMS market has matured, we've seen that customers value different levels of support. Some want that full partnership. Others simply want to own the system outright, the way they would any other piece of capital equipment. Our prior strategy did not allow us to compete within this broader customer universe. To address this, while we're continuing to offer the treatment session model, along with our comprehensive support program, we've also introduced new and different ways a customer can choose to acquire a NeuroStar system. Specifically, they can purchase 1 outright or opt for a lease-financed option, which allows a customer to use the system over time without a significant upfront capital commitment. For customers who elect to purchase a system, we now offer support on an a la carte basis, allowing them to select the specific elements of our clinical and operational support that they want, rather than accessing it through a treatment session model. In each case, customers gain access to the same market-leading technology, and those who choose the session model retain the high-touch support that's always distinguished us. We introduced these approaches on a limited basis earlier this year and expanded the pilot through the second quarter. The early reception was encouraging, and we have since moved to a broader rollout. Over time, as more customers choose to own their systems, more of that value will be reflected in capital revenue, consumables, and service, and less in treatment session revenue. That shift reflects both the demand we're seeing for a capital model and our ability to compete for business that was previously out of reach. Consistent with our expectations, NeuroStar revenue was down slightly versus prior year, with capital revenue up double digits, while treatment session revenue was down double digits versus a year ago. Almost half of the reduction in the sessions revenue reflected the continued normalization of customer inventory, now at the lower levels we'd expect to maintain. The balance was from units no longer active. Underneath that, demand for treatment sessions remained strong within accounts that were active a year ago, with utilization up approximately 10% among them. The broader point is the TMS market itself continues to grow both across the industry and within our accounts. The decline in our session revenue reflects the change in our model, not the demand for the therapy. Ultimately, as we introduce new commercial options and we see some mix shifts, our second-half revenue may be a bit choppier, but the changes position us for renewed and sustainable growth as we enter 2027. We're also continuing to invest in the platform itself. In May, we announced a strategic collaboration with ANT Neuro to co-promote their FDA-cleared neuronavigation technology with NeuroStar. Providers are looking for tools that bring more visualization, consistency, and personalization into how they plan and deliver treatment. And this partnership lets us offer that alongside the NeuroStar system. We have the largest installed base of TMS systems in the country, which gives us the ability to bring innovations like this to market and scale them across the field. Moving to Greenbrook, which was the star of the quarter. The operational discipline that we'd been building into the clinic business continued. Greenbrook revenue was $26.9 million, up approximately 17% year-over-year. Beyond the top-line growth at Greenbrook, our work on revenue cycle management continued to produce results, with cash collections growing even faster than revenue. Focusing on better qualifying patients' eligibility, cleaner claims submissions, and more efficient collections were key contributors, along with improved reimbursement rates through more effective payer contracting across both TMS and SPRAVATO. We also began using AI in the insurance authorization process, which has helped us reduce operating costs. This reflects the operational discipline that we've been building into these clinics, and it's converting into cash, not just billings. And we believe there's still runway ahead of us. The other lever is occupancy. These clinics carry a largely fixed cost base, so the more efficiently we can run each site and the more patients we treat, the more profitable each location becomes. That's where much of our operational focus continues to sit today. With available capacity, we're closely examining our sales methods, including number of field reps, direct-to-consumer ad spend, and peer-to-peer education events, attempting to improve referrals while doing so with the most efficient patient acquisition cost. This, too, remains a meaningful incremental profitability driver. Before we move on, I wanted to provide an update on changes to our senior leadership team. As you might imagine, I spent a fair amount of time in my first 100 days evaluating our leadership team and structure. As a result, I made some changes to our leadership team, including reducing executive headcount and flattening our structure. This should allow us to get and stay closer to the details of the business. Some of the key changes include the recent appointment of Nir Naor as Chief Financial Officer. Nir brings more than 20 years of finance experience across medical device and care delivery businesses, including at his last company, where he helped the business reach profitability and achieve positive cash flow within a year. That experience is directly relevant to our priorities at this stage of our business, and I'm confident he'll be a key thought partner as we execute on our priorities. We also promoted Corey Anderson to Executive Vice President and General Manager of Greenbrook. Cory's been with us more than 5 years overseeing both our technology and clinical data efforts, as well as leading the commercial readiness efforts of psychedelics with our partners at Compass Pathways. Putting a dedicated leader with a rich understanding of the interventional psychiatry space as the head of Greenbrook reflects its importance to our future and the types of initiatives that will help us continue to drive growth in that part of the business. And in June, we appointed Rob Green as Senior Vice President of Sales. Rob spent his career leading commercial organizations across healthcare and medical technology, including in capital equipment and service. As we roll out new commercial models for NeuroStar, Rob's experience will be central to executing that strategy. Separately, we consolidated roles in marketing and operations, and Andy McCann will be stepping down as Chief Legal Officer later this month. With this team in place, we're well-positioned to execute our strategy and the priorities that we're reviewing this morning. Stepping back, we moved forward this quarter on what matters most, competing for NeuroStar customers who were previously out of reach, running our Greenbrook clinics more efficiently, and advancing our goals towards profitability and cash generation. I'll turn it over to Nir to take you through the financials and I'll come back with our outlook for the rest of the year. Nir? Nir Naor: Thank you, Daniel, and good morning, everyone. Let me start with a few thoughts on why I joined and then walk you through the quarter. I came to Neuronetics because I saw a business with a strong core, leading technology, and a national clinical network, as well as a clear opportunity to improve how it converts that into profitability and cash. That is what I've spent my career doing and that is what I intend to focus on here. And to our financials. Unless otherwise noted, all performance comparisons are being made to the second quarter of 2026 versus the second quarter of 2025. Total revenue in the second quarter was $41.6 million, an increase of 9.1% compared to revenue of $38.1 million in the second quarter of 2025. The increase in revenue was primarily driven by higher Greenbrook revenue. With the commercial model update that Dan mentioned in his comments, we intend to update our financial reporting on a go-forward basis to better align with the relevant operational metrics. As customers move between owning a system, financing 1, purchasing support on an a la carte basis, or opting for the traditional session model, the split between capital and treatment session revenue no longer reflects the business in a consistent manner. We plan to manage the total growth of the NeuroStar franchise. With a host of contributing revenue lines such as sessions, capital, lease, service, consumables, and others, comparisons versus the past become less relevant for us. As a result, we will look at our NeuroStar business more holistically and intend to report it as a single revenue line going forward. Accordingly, total revenue from our NeuroStar business was $14.7 million in the second quarter of 2026, a decrease of 2.7%. For context, our session revenue was down double digits and our capital sales were up double digits. Greenbrook revenue was $26.9 million, a 16.8% increase. The results were driven by strong continuous provider growth and overall pricing improvement. Gross margin was 51.1% in the second quarter of 2026 compared to 46.6% in the prior year. This was a function of mix and our improving revenue cycle management efforts. Operational expenses during the quarter were $22.7 million, a decrease of $3.1 million, or 12%, compared to $25.8 million in the second quarter of 2025. This was largely due to lower general and administrative expenses and lower sales and marketing expenses. Continued cost efficiency measures were 1 of the key drivers for that change. Net loss for the quarter was $3.4 million, or $0.05 per share, compared to a net loss of $10.1 million, or $0.15 per share in the prior year. Adjusted EBITDA was positive $0.3 million as compared to negative $5.6 million in the prior year, an improvement of $5.9 million. Moving to the balance sheet and cash flow. As of June 30, total cash was $25 million, consisting of cash, cash equivalents, and restricted cash, as compared to $19 million as of March 31, 2026. Cash used by operations and investing in the second quarter was $1.4 million. This compares to cash used from operations and investing of $3.8 million in Q2 of 2025. During the quarter, we also raised $7.6 million in net proceeds through our at-the-market equity offering. Now turning to guidance. We're narrowing our total revenue range to $160 million to $164 million compared to prior guidance of $160 million to $166 million. We now expect gross margin range to be between 48% and 50% compared to prior guidance of 47% to 49%. We're lowering our OPEX guidance to $95 million to $100 million versus our prior guidance of $100 million to $105 million. The majority of this change is driven by decreased expectation of share-based compensation. Since share-based compensation fluctuates significantly, it's a non-cash component and is difficult to forecast going forward. We're going to guide to OPEX excluding share-based compensation. On this basis, we would expect this number to be $91 million to $96 million for the year. Our current estimate of share-based compensation is $4 million for the year. We're also updating our cash flow guidance to include both cash flow from operations and cash flow from investing as we consider this sum a more representative view of the company's organic cash utilization and estimate it to be in the range of negative $10.5 million to negative $14.5 million for the full year. This is compared to our prior guidance of cash flow from operations only in the range of negative $13 million to negative $17 million. We continue to target limited net cash utilization from operations and investing in the second half of the year. In summary, this was a quarter of solid financial progress. We grew revenue, improved our margins, reduced our cash burn, and strengthened our balance sheet, all while continuing to invest in the growth of the business. Our focus is on converting that progress into sustained profitability and positive operating cash flow. With that, I will turn it back to Dan for his closing remarks. Daniel Reuvers: Thanks, Nir. Let me close with a few thoughts on where we go from here. During the quarter, we continued our collaboration with Compass Pathways to prepare for the anticipated commercial launch of their psychedelic therapeutic for treatment-resistant depression, or TRD. We also shared the stage with them at an investor panel last month to continue to educate the investor community about the potential market dynamics with a new treatment option for providers to prescribe for TRD patients. With their recent Phase 3 extended durability data readout, our enthusiasm for the opportunity continues to grow. The regulatory path is Compass's to run, and I'm not going to get ahead of it, but therapies like this, when they come to market, will require exactly the kind of delivery platform that we already operate. In-office drug delivery and monitoring, REMS programs, trained clinical staff, the benefits investigation and prior authorization infrastructure that we run every day for SPRAVATO. As new psilocybin treatments become available, they'll need places equipped to deliver them safely and at scale. Greenbrook's experience, scale, and available capacity positions us as an early leader in that space as we look forward to providing the most comprehensive menu of interventional psychiatry options for patients. More broadly, our priorities for the rest of the year are clear. We'll continue expanding how we compete within the TMS space with NeuroStar, keep driving operational discipline and cash generation at Greenbrook while seeking to help even more patients, expanding our occupancy, and positioning ourselves for the opportunities ahead in interventional psychiatry. Ultimately, we intend to be the destination of choice for the psychiatry community looking for the most effective treatment interventions for their patients. We have real work in front of us, but we have the team, the resources, and the momentum to see it through. Before I close, I'll note that earlier this month, we announced a constructive understanding with 1 of our largest shareholders, reflecting a shared commitment to maximizing long-term value for our shareholders. The Board and I welcome that alignment, and reinforces the focus we all share on executing the priorities I've laid out this morning. I want to thank our employees for a hard-fought quarter and for the work that they do every day on behalf of the patients that we serve and our shareholders for their continued support. With that, operator, we're ready to open the line for questions. Operator: [Operator Instructions] Our first question comes from the line of William Plovanic with Canaccord. William Plovanic: First of all, congratulations on a solid quarter, you know, definitely improving the cash flow. I'm going to focus on the future rather than the past. In terms of Greenbrook, as you're leaning into this really service offering for all these new psychedelics coming to market, I was wondering if you could help us understand just with the Greenbrook footprint as you go to optimize those, 1, how many rooms are typically available on average per site? 2, as you become more cash-generating, could we expect you to start opening more facilities or expanding the existing facilities? Yes, my understanding is the Compass product is like a 6-hour versus maybe SPRAVATO at about 2 hours of observation. So I'm trying to -- as new drugs come to market, they're going to have different requirements. And how do you address those capacity issues and balance that against revenue. But really, it's on the Greenbrook and just leaning in there. Daniel Reuvers: Yes, good question. Thanks, Bill. So I think, first of all, I'll talk about psychedelics in a minute, but I think that initially, there's a lot of runway that continues to be available to us simply in improving the capacity that's available within so many of our sites. So we've got a fair amount of fixed costs, as you know, and we've talked about having available capacity as much as 40% that's still not consumed. So filling those chairs with patients that can benefit from our therapies is a top priority. And I think we have a lot of improvement to occur even while we're waiting for the psychedelics to be introduced. That said, we think about it more as units of time and available capacity. A lot of these rooms where we treat patients for SPRAVATO can quite easily be converted to also administer psychedelics like COMP360. So I think that we've already got the capacity in the rooms and it's a matter of making sure that we're filling these to better capacity, which is an opportunity for growth that we have even before some of the psychedelics come available. And then as they do, we have been putting a lot of energy into making sure that we're being thoughtful about how we would schedule those varying treatments. As we know, TMS is a matter of minutes, a couple of hours for SPRAVATO, and to your point, probably closer to 6 hours for COMP360, in varying sequences for some of the other therapeutics to come later. We're starting to use AI for scheduling to optimize how we can make sure that we do that in the most productive way. So I think there's a lot of opportunity for us to continue to fill that capacity. And once we do, once we start to get closer to that and we need more space, certainly more sites or expanding those footprints is well within our roadmap. But initially, I think there's so much unused capacity, we'll really focus there first, and then sequentially there will be an opportunity for us to look at expansion. William Plovanic: Excellent. If I could have 1 follow-up. Just on, you know, you've come in and you've made a lot of, you've cut a lot of costs. I mean, definitely have improved the operating structure of the business. You know, as you think of that mission from here forward with the recent announcements you've made and the changes in management, you know, are you through kind of the bulk of the changes and here it's more incremental tweaking from a cost structure? Or just how should we think about the opportunity for further efficiency gains in the operating structure? Daniel Reuvers: Yes, I think that a natural thing is sometimes we don't always look in the mirror first as executives. So, starting with the leadership ranks and trying to make sure that the structure and the people that fill the right roles was established, I feel really good about where we sit today. I think we've added some really good talent. I think we've redistributed some of the assignments to some really talented up-and-coming folks within the organization. So I think that we, I feel like we sit quite well there. I think there's probably still opportunities for us. I think this is where having a new CFO flanking me with just a couple of weeks under his belt, he and I will have an opportunity to more comprehensively continue to examine where those additional opportunities might exist. But organizationally, I feel like we've made a lot of progress and I'm feeling very good about kind of how we've anchored ourselves at this point. Operator: Our next question comes from the line of Danny Stauder with Citizens Bank. Daniel Stauder: Really nice quarter, and Nir, congrats on the new role, and it's great to have you on the call. Just on my first 1, I want to make sure of understanding the NeuroStar treatment session dynamic here. So it sounds like the normalization of inventory should continue through the rest of the year. So it should continue to be down, maybe with some offset from gains in capital. So I just want to make sure that's the right way to be thinking about it. And then do you think this is more of a dynamic for just new customers or do you expect, you know, a larger portion of your existing customers to transition to some of these other models and offerings that you have? Daniel Reuvers: Yes, thanks, Danny. Appreciate the question. I think on the sessions inventory, just to be clear, we feel like that the inventories are down about as low as we would expect them to be maintained. So, I don't see any continued inventory reductions in the back half of the year. I think we've, after the second quarter, I think largely equilibrated to where we think normal sustainable inventories would be. So I don't see that as much of a headwind in the back half as perhaps in the second quarter. I think from an existing customer standpoint, 1 of the things I want to make sure doesn't get lost is a comment I made in the prepared remarks, we know that our chairs receive almost twice as much velocity -- patient velocity as the competitive landscape. So we certainly think that a lot of the customers that have selected us did so largely because of the comprehensive support we provide and the kind of improvements it makes in their own practice. So I think that we expect that the majority probably of those sessions customers who have benefited from that level of comprehensive service will continue in that vein. We will certainly offer more options, and that's what we've been talking about in our new go-to-market strategy is we want to let the customer decide where they see the value and how they want to pay for it. So I think the other point to be made is that if a customer, a new customer for example, chose the capital route versus the traditional sessions route, they'll still pay for things like service and consumables and training, and those things are currently embedded in the sessions structure. And it's 1 of the reasons that we chose to start to report on this on a more holistic basis, because there's probably going to be some noise moving back and forth, and I think that it's important to appreciate that some of the consumables, some of the service, that revenue that we've gotten has been embedded in the sessions revenue side. So, you know, we're going to give customers the option to decide how they want to pay for the value that we bring. But ultimately, I think that while we will expect to open ourselves up to new socket placements with this broader go-to-market, we're also hearing that there's a big segment of our customer base that remind us why they picked us in the first place, and that's that comprehensive support that we provide. Daniel Stauder: That's great. Appreciate that. And then just 1 quick follow-up for me. It's great to see the improvement on operating expenses and below the top line. I wanted to focus on gross margin, just that line was really strong, even with clinic revenue being the primary driver of growth and making up a larger mix of sales. So could you just give us a little bit more color on what drove that gross margin expansion here? I think you called out some pricing improvement within clinics, so any color there or just anything else on the execution would be great. Daniel Reuvers: Sure, yes, that's certainly a high point for the quarter. And as you know, we raised our guidance on gross margin for the full year. So we think that some of these improvements are durable. And the good news, I think, also is that we saw support or strength in the gross margin on both the Greenbrook and the NeuroStar side. So, on the Greenbrook side, a lot of it has to do with improved revenue cycle management. And that is as we make sure that we're being more disciplined about patient qualification, which is good for the patient as well. They don't want to find out that they don't meet the right criteria when they're 3 sessions in. So that's going to focus. That leads to cleaner claims and more efficient accounts receivable. So all of those things mean you capture a bit better revenue on a billed dollar than we did in the past. And I think those are durable, and those are clearly things that are contributing to the better gross margin on Greenbrook, along with some pricing relative to our team's work with some of the third-party payers. On the NeuroStar side, while sessions revenue was off a bit and capital was up, I think it also points to the fact that as our mix starts to equilibrate more and it's not exclusively on the sessions side, our ASP is going up. So as that growth occurs in capital, I think that, that can be also a sustainable good guide for us on the gross margin side. Of course, both of those considerations are embedded in our updated guidance. Operator: Our next question comes from the line of Sam Eiber with BTIG. Sam Eiber: Maybe I can start on the Greenbrook side, a really strong quarter on that side of the business. Dan, wondering if you could help parse out maybe some of the underlying trends you're seeing on the SPRAVATO side versus the TMS side of the business. And then, you know, just as I think about Compass and psilocybin entering the market, you know, perhaps next year, maybe just talk about how, you know, your model is set up best by offering, you know, SPRAVATO, TMS, psilocybin, and why that's the best model for patients. Daniel Reuvers: Yes, so just making a quick note here. So I think first of all on the SPRAVATO versus TMS, we saw a bit more strength probably from SPRAVATO even than TMS, but I think the fact that the overall business is growing is just a good reflection of the fact that Greenbrook's becoming an increasing destination of choice for referral sources. The SPRAVATO business is certainly more durable, as I think I've alluded to in the past. The duration between treatments, even after an initial round, continues to be more sustainable. I guess that's good for us from a patient standpoint. It means they have to revisit us a bit more frequently. So those patients tend to stay more active for a longer period of time within our network. I think on the Compass side, I think there's a number of things that I alluded to in our comments earlier that really position us well. I think we're really poised to be a first-mover benefactor, just in part because of the close collaboration we've had with them and some of the preparation benefits, but also the infrastructure that we talked about that already exists because of our SPRAVATO participation. The REMS certification, the rooms, setups, the capacity availability, all of those things I think lend themselves to positioning us in kind of a pole position. And I think the other 1, Sam, is a little bit about kind of your question about the blend. We really want to position ourselves with referral sources as the destination of choice for whatever intervention is best suited for that patient within the interventional psychiatry scope. I think that we've already done that with TMS, with Spravato, we look forward to doing it with Compass, and I think as additional new therapeutics come out, we are positioning ourselves, both infrastructure and on brand, that we really want to be the destination that they can entrust their patients. The fact that we don't do medical management and psychotherapy also gives those referral sources the confidence that they can send their patients to us and know that they'll get them back. I think all of those are important parts of kind of the ecosystem we're trying to build. Sam Eiber: That's really helpful, Dan. Thanks for the added color there. Maybe I can just use a follow-up here on some of the comments around different sales methods you're going to be evaluating with regard to field reps and direct-to-consumer spending. Are there certain KPIs that you'll be tracking or that we should be mindful of as you, I guess, evaluate, you know, efficiently getting more patients through the door here? Daniel Reuvers: Yes, I think, so externally, KPIs, I think you can ultimately look at our operating expenses, of course internally. The patient acquisition cost is 1 that we're taking a more scrutinizing look at. And I can say quite confidently that the account managers that support the Greenbrook community are proving to be a very effective source for referral generation. I think we want to take a closer look at the balance in spend between our field team and some of our direct-to-consumer ad spend, along with some of the other things that we do from a peer-to-peer education. And we're just trying to be a lot more thoughtful about trying to evaluate what each 1 of those costs and which ones are returning the most effectively. I would expect that we will probably pull and push on some levers, try and rebalance some and balance our spend in the most effective paths and at the expense of some of the others. So some of that work continues to go on. There's a lot of analytics that we're working on, but at the end of the day, it really comes down to our patient acquisition cost and what's the most efficient way to get the right patient who can benefit from our therapies in a chair. Operator: I am showing no further questions in the queue. I would now like to turn the call back over to Dan Reuvers for any closing comments. Daniel Reuvers: Thanks, Operator, and thank you to everyone for joining today's call. We really look forward to updating you on our progress during our next quarterly call and hope everybody has a good rest of the summer. Thank you. Operator: This concludes today's conference call. Thank you for your participation and you may now disconnect. 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Our analysts just identified a stock with the potential to be the next Nvidia. Tell us how you invest and we'll show you why it's our #1 pick. Tap here. Shifted to a hybrid go-to-market model for NeuroStar, offering capital purchase and lease-finance options alongside the traditional treatment session model to capture previously unreachable market segments. Achieved 17% year-over-year growth at Greenbrook clinics, driven by improved revenue cycle management, cleaner insurance claims, and AI-assisted authorization processes. Reported a 10% utilization increase in active NeuroStar accounts, indicating that the decline in session revenue was a result of model transition and inventory normalization rather than waning therapy demand. Implemented a leadership restructuring to flatten the organization and reduce executive headcount, aiming to stay closer to operational details and accelerate the path to profitability. Leveraged fixed-cost clinic infrastructure to improve margins, focusing on filling approximately 40% available capacity through optimized patient acquisition costs. Formed a strategic collaboration with ANT Neuro to integrate neuronavigation technology, enhancing the NeuroStar platform's visualization and personalization capabilities. Anticipates 'choppier' revenue in the second half of 2026 due to the commercial model shift, positioning the company for sustainable growth entering 2027. Targets limited net cash utilization from operations and investing for the remainder of the year, supported by narrowed revenue and improved gross margin guidance. Positions Greenbrook as a primary delivery platform for upcoming psychedelic therapeutics, utilizing existing REMS infrastructure and clinical capacity for future drug launches. Focuses on rebalancing sales investments between field representatives and direct-to-consumer spending to optimize patient acquisition costs. Assumes inventory levels for treatment sessions have equilibrated to sustainable lows, removing a significant headwind for the back half of the year. Transitioned to holistic NeuroStar revenue reporting, combining capital, sessions, and service into a single line to reflect the new flexible commercial options. Reduced operating expense guidance by $5 million, primarily reflecting lower expectations for non-cash share-based compensation. Appointed a new CFO with a specific mandate to convert the company's leading technology and clinical network into sustained profitability and positive cash flow. Reached a constructive understanding with a major shareholder to align on long-term value creation and strategic execution. One stock. Nvidia-level potential. 30M+ investors trust Moby to find it first. Get the pick. Tap here. Management highlighted 40% unused capacity in existing clinics that can be filled before requiring physical footprint expansion. Existing SPRAVATO rooms are easily convertible for longer-duration psychedelic treatments like COMP360, with AI being used to optimize complex scheduling. Expansion of facilities remains on the roadmap but is secondary to maximizing current fixed-cost efficiency. Margin gains are considered durable, driven by disciplined patient qualification and better payer contracting at Greenbrook. NeuroStar margins benefited from higher Average Selling Prices (ASPs) as the mix shifted toward capital equipment sales. Management raised full-year gross margin guidance to 48%-50% based on these structural improvements. Greenbrook aims to be a 'destination of choice' by offering a menu of interventions (TMS, SPRAVATO, psychedelics) without competing for medical management or psychotherapy. The model relies on maintaining trust with referral sources by returning patients to their primary providers after specialized interventional treatment.

This article first appeared on GuruFocus. Total Revenue: $41.6 million, up 9.1% year-over-year. NeuroStar Revenue: $14.7 million, down 2.7% year-over-year. Greenbrook Revenue: $26.9 million, up 16.8% year-over-year. Gross Margin: 51.1%, up from 46.6% in the prior year. Operational Expenses: $22.7 million, down 12% year-over-year. Net Loss: $3.4 million, or $0.05 per share, compared to a net loss of $10.1 million, or $0.15 per share, in the prior year. Adjusted EBITDA: Positive $0.3 million, compared to negative $5.6 million in the prior year. Cash Position: Total cash of $25 million as of June 30, 2026. Cash Used in Operations and Investing: $1.4 million in Q2 2026, compared to $3.8 million in Q2 2025. Full-Year Revenue Guidance: Narrowed to $160 million to $164 million. Full-Year Gross Margin Guidance: Raised to 48% to 50%. Full-Year OpEx Guidance (excluding share-based compensation): $91 million to $96 million. Full-Year Cash Flow Guidance (operations and investing): Negative $10.5 million to negative $14.5 million. Warning! GuruFocus has detected 5 Warning Signs with STIM. Is STIM fairly valued? Test your thesis with our free DCF calculator. Release Date: August 11, 2026 For the complete transcript of the earnings call, please refer to the full earnings call transcript. Total revenue increased 9.1% year-over-year to $41.6 million, driven by strong Greenbrook growth. Greenbrook revenue grew 16.8% to $26.9 million, with cash collections growing faster than revenue due to improved revenue cycle management. Gross margin improved to 51.1% from 46.6% in the prior year, driven by better payer contracting and revenue cycle management. Net loss narrowed significantly to $3.4 million from $10.1 million, and adjusted EBITDA turned positive at $0.3 million. Cash burn reduced substantially, with cash used in operations and investing down to $1.4 million from $3.8 million in Q2 2025, and total cash increased to $25 million. NeuroStar total revenue declined 2.7% year-over-year, with treatment session revenue down double digits due to model changes and customer inventory normalization. The shift to new commercial models (capital purchases, leases) may cause revenue to be 'choppier' in the second half of 2026. The company reduced executive headcount and flattened structure, indicating potential organizational disruption. Cash flow guidance remains negative for the full year, with expected cash use of $10.5 million to $14.5 million. The company's reliance on the success of the new go-to-market pilot and the potential for existing customers to transition away from the high-touch session model introduces uncertainty. Q: As you lean into the service offering for new psychedelics coming to market, how many rooms are typically available per Greenbrook site, and could we expect you to start opening more facilities or expanding existing ones as you become more cash-generating?A: Dan Reuvers (CEO): There is significant runway in improving the capacity available within our existing sites, with as much as 40% of capacity still not consumed. Filling those chairs is a top priority. Rooms used for Spravato can be easily converted to administer psychedelics like COMP360. We are using AI for scheduling to optimize how we deliver varying treatments (TMS, Spravato, and longer-duration psychedelics). Once we get closer to full capacity, expanding footprints or opening more sites is within our roadmap, but the immediate focus is on utilizing existing unused capacity. Q: Are you through the bulk of the cost structure changes, or should we think about further opportunities for efficiency gains in the operating structure?A: Dan Reuvers (CEO): We have made significant progress in the leadership ranks, adding good talent and redistributing assignments to capable internal folks. Organizationally, we feel well-positioned. However, with the new CFO, Nir Naor, we will continue to comprehensively examine where additional opportunities might exist, so there are likely still opportunities for further efficiency gains. Q: Should we expect the NeuroStar treatment session inventory normalization to continue through the rest of the year, and do you expect a larger portion of existing customers to transition to the new capital models?A: Dan Reuvers (CEO): Inventories have largely equilibrated to normal sustainable levels after the second quarter, so we don't see continued inventory reductions as a headwind in the back half. We expect the majority of existing session-model customers will continue with the comprehensive support model, as our chairs perform almost twice as many treatments per chair as the competitive landscape. However, we are offering more options to let customers decide how they want to pay for value. If a new customer chooses the capital route, they will still pay for service, consumables, and training, which is why we are reporting NeuroStar on a more holistic basis. Q: What drove the strong gross margin expansion, especially with clinic revenue making up a larger mix of sales?A: Dan Reuvers (CEO): The gross margin strength was seen on both the Greenbrook and NeuroStar sides. On the Greenbrook side, it was driven by improved revenue cycle management, including better patient qualification, cleaner claims submissions, and more efficient accounts receivable, along with improved reimbursement rates through more effective payer contracting. On the NeuroStar side, as the mix shifts more toward capital sales, the average selling price is going up, which is a sustainable positive for gross margins. These considerations are embedded in our updated guidance. Q: Can you parse out the underlying trends on the Spravato side versus the TMS side of the Greenbrook business, and how is your model best set up to offer Spravato, TMS, and psilocybin?A: Dan Reuvers (CEO): We saw a bit more strength from Spravato than TMS, but overall growth reflects Greenbrook becoming a destination of choice for referral sources. Spravato is more durable as patients stay active longer. Regarding Compass and psilocybin, we are poised to be a first-mover benefactor due to our close collaboration and existing infrastructure, including REMS certification, room setups, and available capacity. We aim to be the destination of choice for referral sources for whatever intervention is best suited for the patient, and our model of not doing medical management and psychotherapy gives referral sources confidence they will get their patients back. Q: Are there certain KPIs you will be tracking as you evaluate efficiently getting more patients through the door with different sales methods?A: Dan Reuvers (CEO): Internally, patient acquisition cost is a key metric we are scrutinizing. Account managers supporting the Greenbrook community are proving to be a very effective source for referral generation. We are evaluating the balance of spend between our field team, direct-to-consumer ad spend, and peer-to-peer education events, and we will rebalance spend toward the most effective paths. The ultimate goal is finding the most efficient way to get the right patient who can benefit from our therapies into a chair. Q: Can you provide more color on the second-quarter financial results and the updated guidance?A: Nir Naor (CFO): Total revenue was $41.6 million, up 9.1% year-over-year, driven primarily by Greenbrook revenue of $26.9 million, up 16.8%. NeuroStar revenue was $14.7 million, down 2.7%, with capital sales up double digits and session revenue down double digits. Gross margin was 51.1%, up from 46.6%, due to mix and improved revenue cycle management. Operating expenses decreased 12% to $22.7 million. Net loss improved to $3.4 million from $10.1 million, and adjusted EBITDA was positive $0.3 million versus negative $5.6 million. We are narrowing total revenue guidance to $160-$164 million, raising gross margin guidance to 48%-50%, and lowering OpEx guidance to $91-$96 million excluding share-based compensation. Q: What is the status of the collaboration with Compass Pathways and the potential for psychedelic therapeutics?A: Dan Reuvers (CEO): We continued our collaboration with Compass Pathways to prepare for the anticipated commercial launch of their psychedelic therapeutic for treatment-resistant depression. With their recent Phase 3 extended durability data readout, our enthusiasm for the opportunity continues to grow. When these therapies come to market, they will require the kind of delivery platform we already operate, including in-office drug delivery, REMS programs, trained clinical staff, and prior authorization infrastructure. Greenbrook's experience, scale, and available capacity positions us as an early leader in that space. Q: How should we think about the cash flow guidance and the company's path to profitability?A: Nir Naor (CFO): We are updating our cash flow guidance to include both cash flow from operations and investing, estimating it to be in the range of negative $10.5 million to negative $14.5 million for the full year. We continue to target limited net cash utilization for operations and investing in the second half of the year. Our focus is on converting progress into sustained profitability and positive operating cash flow. During the quarter, we raised $7.6 million in net proceeds through our at-the For the complete transcript of the earnings call, please refer to the full earnings call transcript.

MALVERN, Pa., Aug. 11, 2026 (GLOBE NEWSWIRE) -- Neuronetics, Inc. (NASDAQ: STIM) (the “Company” or “Neuronetics”), a leader in interventional mental health that combines its NeuroStar® TMS technology with direct patient care through the Greenbrook network of interventional psychiatry clinics, today announced its financial and operating results for the second quarter of 2026. Second Quarter 2026 Financial Highlights Total revenue of $41.6 million, up 9.1% compared to the second quarter of 2025 Greenbrook revenue of $26.9 million, up 16.8% compared to the second quarter of 2025 Adjusted EBITDA of $0.3 million compared to a loss of $5.6 million in the second quarter of 2025 Net loss of $3.4 million compared to a loss of $10.1 million in the second quarter of 2025 Net cash used in operations and investing of $1.4 million, a reduction of $2.3 million compared to $3.8 million in the second quarter of 2025 Recent Operational Highlights Nir Naor appointed as Executive Vice President, Chief Financial Officer, Corporate Secretary, and Treasurer Cory Anderson promoted to Executive Vice President/General Manager of Greenbrook clinics Rob Greene appointed as Senior Vice President, Sales "This was a quarter of real operational progress, and meaningful steps toward our goal of sustained profitability and positive net cash flow from operations and investing," said Dan Reuvers, President and Chief Executive Officer of Neuronetics. "For some time, NeuroStar has not competed to its full potential, and we are changing that by broadening how customers can access our technology while we continue to drive operational gains across the Greenbrook clinics. We also strengthened our leadership team, adding proven talent in key roles. The combination of a leading TMS platform and a national care network is what sets Neuronetics apart, and it positions us to lead as new interventional therapies come to market. There is more work ahead, but I am encouraged by the traction we are beginning to demonstrate." Second Quarter 2026 Financial and Operating Results for the Three Months Ended June 30, 2026 Total revenue for the three months ended June 30, 2026 was $41.6 million, an increase of $3.5 million, or 9.1%, compared to the three months ended June 30, 2025 of $38.1 million. The increase was primarily driven by higher Greenbrook revenue, which increased to $26.9 million in the second quarter of 2026 from $23.0 million in the second quarter of 2025, reflecting continued growth of the Greenbrook business. Gross margin increased from 46.6% for the three months ended June 30, 2025 to 51.1% for the three months ended June 30, 2026. The increase in gross margin was driven by the positive impact of our new go-to-market strategy, as well as improved revenue cycle management within the Greenbrook clinics. Operating expenses during the second quarter of 2026 were $22.7 million, a decrease of $3.1 million, or 12%, compared to $25.8 million in the second quarter of 2025, primarily attributable to lower general and administrative expenses and lower sales and marketing expenses. Loss from operations during the second quarter of 2026 was $1.5 million, a decrease of $6.6 million, as compared to a loss of $8.1 million in the second quarter of 2025. Adjusted EBITDA during the second quarter of 2026 was $0.3 million, an increase of $5.9 million compared to a loss of $5.6 million in the second quarter of 2025.Net loss for the second quarter of 2026 was $3.4 million, or $0.05 per share, as compared to $10.1 million, or $0.15 per share, in the second quarter of 2025. Net loss per share was based on 73,129,107 and 66,180,069 weighted average common shares outstanding for the second quarters of 2026 and 2025, respectively. As of June 30, 2026, the Company held $25 million in total cash, consisting of cash and cash equivalents of $19.2 million and $5.8 million of restricted cash, compared to total cash of $34.1 million as of December 31, 2025. Strengthened Leadership Team The Company made a series of changes to strengthen its senior leadership team and align its structure with the Company's priorities. Nir Naor was appointed Executive Vice President, Chief Financial Officer, Corporate Secretary, and Treasurer, bringing more than 20 years of finance leadership across medical device and care-delivery businesses, including experience guiding a company to profitability and positive cash flow. Cory Anderson, a five-year veteran of the Company, was promoted to Executive Vice President and General Manager of Greenbrook, reflecting the growing importance of the clinic business. Rob Greene joined as Senior Vice President, Sales, bringing extensive commercial leadership across healthcare and medical technology, including capital equipment and service, to support the Company's expanded NeuroStar go-to-market models. Business Outlook For the full year 2026, Neuronetics expects: Total revenue between $160 million and $164 million, as compared to prior guidance of $160 million and $166 million; Gross margin between 48% and 50%, as compared to prior guidance of 47% and 49%; Operating expenses between $95 million to $100 million, compared to prior guidance of $100 million to $105 million. Going forward, operating expense guidance will exclude stock-based compensation. On this basis, operating expenses are expected to be $91 million to $96 million, with estimated stock-based compensation of $4 million. Cash flow from operations and investing in the range of negative $10.5 million to negative $14.5 million. This is compared to our prior guidance of cash flow from operations only in the range of negative $13 million to negative $17 million. Non-GAAP Financial Measures (Unaudited) Operating Expense Guidance: FY 2026 The following table presents the Company’s reconciliation between Operating Expenses and Operating Expenses less Non-cash Stock- Based Compensation. This adjusted guidance is based on assumptions that management believes are reasonable under the circumstances. However, they are not necessarily indicative of the Company’s future performance. Operating Expenses less Stock Based Compensation are projected Operating Expenses for the fiscal year 2026, less non-cash stock-based compensation. (1) Stock-based compensation consists of expenses related to restricted stock units and performance based restricted stock units. We exclude these expenses from our non-GAAP financial measures because they are non-cash charges that we do not consider reflective of our core ongoing operational performance. While share-based compensation is a recurring expense and a key part of our employee retention strategy, excluding it allows management and investors to compare our operational profitability more consistently against prior periods and industry peers.Webcast and Conference Call Information The conference call will be broadcast live in listen-only mode via webcast at https://edge.media-server.com/mmc/p/7ri4xna9. To listen to the conference call on your telephone, participants may register for the call here. While it is not required, it is recommended you join 10 minutes prior to the event start About Neuronetics Neuronetics, Inc. is a leader in interventional mental health, combining innovative treatment technologies with direct patient care. Through its NeuroStar® Advanced Therapy system, the Company is a leading provider of transcranial magnetic stimulation (“TMS”) treatment and, through Greenbrook TMS Inc. (“Greenbrook”), operates one of the largest interventional psychiatry clinic networks in the United States, offering both TMS and SPRAVATO® therapies. NeuroStar Advanced Therapy is a non-drug, noninvasive treatment that can improve the quality of life for people suffering from neurohealth conditions when traditional medication has not helped. NeuroStar Advanced Therapy is the leading TMS treatment for major depressive disorder (“MDD”) in adults and is backed by what we believe is the largest clinical data set of any TMS treatment system for depression. Greenbrook treatment centers also offer SPRAVATO® (esketamine) nasal spray, a prescription medicine indicated for the treatment of treatment-resistant depression (“TRD”) in adults as monotherapy or in conjunction with an oral antidepressant. It is also indicated for depressive symptoms in adults with MDD with acute suicidal ideation or behavior in conjunction with an oral antidepressant.1 The NeuroStar Advanced Therapy System is cleared by the U.S. Food and Drug Administration for adults with MDD, as an adjunct for adults with obsessive-compulsive disorder, to decrease anxiety symptoms in adult patients with MDD that may exhibit comorbid anxiety symptoms (anxious depression), and as a first line adjunct for the treatment of MDD in adolescent patients aged 15-21. For safety information and indications for use, visit NeuroStar.com. “Safe harbor” statement under the Private Securities Litigation Reform Act of 1995: Certain statements in this press release, including the documents incorporated by reference herein, include “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), Section 21E of the Securities Exchange Act of 1934, as amended, which are intended to be covered by the safe harbors created by those laws and other applicable laws and “forward-looking information” within the meaning of applicable Canadian securities laws. Statements in this press release that are not historical facts constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements may be identified by terms such as “may,” “will,” “would,” “should,” “expect,” “plan,” “design,” “anticipate,” “could,” “intend,” “target,” “project,” “contemplate,” “believe,” “estimate,” “predict,” “potential,” “outlook” or “continue” as well as the negative of these terms and similar expressions. These statements include those relating to the Company’s business outlook and current expectations for upcoming quarters and fiscal year 2026, including with respect to revenue, expenses, growth, and any statements of assumptions underlying any of the foregoing items. These statements are subject to significant risks and uncertainties and actual results could differ materially from those projected. The Company cautions investors not to place undue reliance on the forward-looking statements contained in this press release. These risks and uncertainties include, without limitation, risks and uncertainties related to: the effect of the transaction with Greenbrook on our business relationships; operating results and business generally; our ability to execute our business strategy; our ability to achieve or sustain profitable operations due to our history of losses; our reliance on the sale and usage of our NeuroStar Advanced Therapy System to generate revenues; the scale and efficacy of our salesforce; our ability to retain talent; availability of coverage and reimbursement from third-party payors for treatments using our products; physician and patient demand for treatments using our products; developments in respect of competing technologies and therapies for the indications that our products treat; product defects; our ability to obtain and maintain intellectual property protection for our technology; developments in clinical trials or regulatory review of the NeuroStar Advanced Therapy System for additional indications; developments in regulation in the U.S. and other applicable jurisdictions; potential effects of evolving and/or extensive government regulation; the terms of our credit facility; our self-sustainability; existing cash balance; our ability to achieve positive cash flows; and our ability to continue as a going concern. For a discussion of these and other related risks, please refer to the Company’s recent filings with the U.S. Securities and Exchange Commission (the “SEC”), which are available on the SEC’s website at www.sec.gov, including, without limitation, the factors described under the heading “Risk Factors” in Neuronetics’ Annual Report on Form 10-K for the fiscal year ended December 31, 2025 and the company’s Quarterly Report on Form 10-Q for the quarter ending June 30, 2026, as may be updated or supplemented by subsequent reports that Neuronetics has filed or files with the SEC. These forward-looking statements are based on the Company’s expectations and assumptions as of the date of this press release. Except as required by law, the Company undertakes no duty or obligation to update any forward-looking statements contained in this press release as a result of new information, future events, or changes in the Company’s expectations. Investor Contact: Mike Vallie or Mark KlausnerICR [email protected] Media Contact: [email protected] Non-GAAP Financial Measures (Unaudited) EBITDA and adjusted EBITDA are not measures of financial performance under generally accepted accounting principles in the U.S. (“GAAP”), and should not be construed as a substitute for, or superior to, GAAP net loss. However, management uses both the GAAP and non-GAAP financial measures internally to evaluate and manage the Company’s operations and to better understand its business. Further, management believes that the addition of the non-GAAP financial measures provides meaningful supplementary information to, and facilitates analysis by, investors in evaluating the Company’s financial performance, results of operations and trends. The Company’s calculation of EBITDA and adjusted EBITDA may not be comparable to similarly designated measures reported by other companies, because companies and investors may differ as to what type of events warrant adjustment. The following table reconciles reported net loss to EBITDA and adjusted EBITDA: Footnotes Stock-based compensation consists of expenses related to restricted stock units and performance based restricted stock units. We exclude these expenses from our non-GAAP financial measures because they are non-cash charges that we do not consider reflective of our core ongoing operational performance. While share-based compensation is a recurring expense and a key part of our employee retention strategy, excluding it allows management and investors to compare our operational profitability more consistently against prior periods and industry peers. In connection with its $5 million repayment of debt in the first quarter of 2026 to Perceptive Advisors, LLC, the Company recorded a total loss on partial debt extinguishment of approximately $0.5 million. This infrequent and non-recurring expense is removed from EBITDA in order to provide a more accurate reflection of the Company’s core operational performance for the period presented. Restructuring expense represents net costs incurred in connection with leadership workforce reductions, role eliminations, or organizational restructuring activities, that are not expected to recur in the ordinary course of business. These costs have been added back to EBITDA because they are considered non-recurring and not reflective of the Company’s ongoing operating performance. Management believes excluding these expenses provides a more meaningful measure of normalized earnings and period-to-period operating comparability. References 1 The effectiveness of SPRAVATO in preventing suicide or in reducing suicidal ideation or behavior has not been demonstrated. Use of SPRAVATO does not preclude the need for hospitalization if clinically warranted, even if patients experience improvement after an initial dose of SPRAVATO. For more important safety information about SPRAVATO, please visit spravatohcp.com.

Interested in Neuronetics, Inc.? Here are five stocks we like better. Q2 results improved significantly: Revenue rose 9.1% year over year to $41.6 million, while the net loss narrowed to $3.4 million and adjusted EBITDA turned positive at $0.3 million. Greenbrook was the primary growth driver: Clinic revenue increased 16.8% to $26.9 million, supported by provider growth, pricing gains, better collections and revenue-cycle improvements. Management estimates some clinics have up to 40% unused capacity, creating further growth potential. Neuronetics broadened NeuroStar sales models and raised profitability targets: Customers can now purchase or lease systems in addition to using the traditional treatment-session model. Full-year guidance includes higher gross-margin expectations and lower operating expenses, although management warned that second-half revenue could be more variable during the transition. Neuronetics (NASDAQ:STIM) reported second-quarter 2026 revenue growth, a sharply narrower net loss and positive adjusted EBITDA as its Greenbrook clinic business expanded and the company introduced additional commercial purchasing options for its NeuroStar transcranial magnetic stimulation, or TMS, systems. Total revenue rose 9.1% year over year to $41.6 million, compared with $38.1 million in the second quarter of 2025. The company recorded a net loss of $3.4 million, or $0.05 per share, versus a $10.1 million loss, or $0.15 per share, a year earlier. Adjusted EBITDA turned positive at $0.3 million, improving from negative $5.6 million in the prior-year period. → SoundHound AI Sends a Loud Signal After Its Q2 Earnings Beat Greenbrook revenue increased 16.8% to $26.9 million, supported by provider growth and pricing improvement, Chief Financial Officer Nir Naor said. Chief Executive Officer Dan Reuvers said the clinic network benefited from operational work in revenue cycle management, including improved patient eligibility qualification, cleaner claims submissions, more efficient collections and payer contracting for both TMS and SPRAVATO treatments. Cash collections grew faster than Greenbrook revenue during the quarter, according to Reuvers. The company also began using artificial intelligence in its insurance authorization process, which he said helped reduce operating costs. → 3 Dividend Champion Utilities for a Market That Can't Sit Still Reuvers said occupancy remains a major opportunity because Greenbrook clinics have a largely fixed cost base and still have available capacity. In response to an analyst question, he said the company estimates that as much as 40% of capacity remains unconsumed at certain sites. Neuronetics is assessing its field-representative coverage, direct-to-consumer advertising and peer-to-peer education efforts in an effort to improve referrals and lower patient acquisition costs. On treatment trends within Greenbrook, Reuvers said the company saw somewhat greater strength in SPRAVATO than in TMS. He said SPRAVATO patients tend to remain active in the network for longer periods after their initial course of treatment. → Is Wingstop's Growth Story Losing Steam? Worldwide NeuroStar revenue totaled $14.7 million, down 2.7% year over year. The company said capital revenue increased by double digits while treatment-session revenue declined by double digits. Neuronetics historically offered its systems largely through a treatment-session model that bundled a high-touch support relationship with the equipment. During the quarter, the company broadened a pilot program offering customers the ability to purchase a NeuroStar system outright or use lease financing. Customers that buy a system can select clinical and operational support services on an à la carte basis. Reuvers said the additional models are intended to allow Neuronetics to compete for customers that prefer to acquire TMS equipment as a capital purchase. He said customers using the traditional session model will continue to receive the comprehensive support offering. The decline in session revenue partly reflected continuing customer inventory normalization, with almost half of the reduction tied to inventory levels reaching what management considers sustainable lower levels. The remainder came from units that were no longer active. However, utilization among accounts that were active a year earlier rose about 10%, Reuvers said. Management expects no further material inventory reduction in the second half of the year. Still, Reuvers cautioned that revenue could be “a bit choppier” in the second half as customers choose among the newer commercial models and revenue shifts among capital sales, service, consumables, leasing and sessions. Because those choices alter the historical split between capital and session revenue, Naor said Neuronetics plans to report NeuroStar as a single revenue line going forward rather than emphasizing the prior revenue categories separately. Neuronetics also announced in May a collaboration with ANT Neuro to co-promote ANT Neuro’s FDA-cleared neuro-navigation technology alongside the NeuroStar system. Reuvers said the offering is designed to provide clinicians with greater visualization, consistency and personalization in treatment planning and delivery. Gross margin increased to 61.1% from 46.6% in the prior-year quarter. Naor attributed the improvement to revenue mix and revenue cycle management efforts. Reuvers said improved patient qualification, claims processing and collections increased the amount of revenue captured per billed dollar at Greenbrook, while pricing improvements from payer contracting also contributed. Operating expenses fell 12% to $22.7 million from $25.8 million, primarily due to lower general and administrative expenses and lower sales and marketing expenses. The company’s cost-efficiency measures were a key contributor, Naor said. As of June 30, Neuronetics had $25 million of total cash, cash equivalents and restricted cash, compared with $19 million at March 31. Cash used by operations and investing was $1.4 million in the quarter, compared with $3.8 million in the prior-year period. The company also raised $7.6 million in net proceeds through its at-the-market equity offering. Neuronetics narrowed its 2026 total revenue guidance to $160 million to $164 million from a prior range of $160 million to $166 million. It raised expected gross margin to 48% to 50%, from 47% to 49%, and lowered operating-expense guidance to $95 million to $100 million from $100 million to $105 million. The company said it will also provide operating-expense guidance excluding share-based compensation, which it expects to be $91 million to $96 million for the year. Its current estimate for share-based compensation is $4 million. Neuronetics now expects combined cash flow from operations and investing to range from negative $10.5 million to negative $14.5 million for 2026. Management said it continues to target limited net cash utilization from operations and investing during the second half. Looking ahead, Reuvers said the company is continuing preparations with Compass Pathways for a potential commercial launch of Compass’s psychedelic therapeutic for treatment-resistant depression, subject to Compass’s regulatory process. He said Greenbrook’s existing infrastructure for in-office drug delivery, monitoring, REMS programs, clinical staffing, benefits investigation and prior authorization could position the network to administer new therapies if they reach the market. The company also made leadership changes, including Naor’s appointment as CFO, Cory Anderson’s promotion to executive vice president and general manager of Greenbrook, and Rob Greene’s appointment as senior vice president of sales. Reuvers said Neuronetics reduced executive headcount, flattened its organizational structure and consolidated certain marketing and operations roles. Chief Legal Officer Andrew Macan is expected to step down later in August. Neuronetics, Inc is a commercial‐stage medical technology company that develops and markets non-invasive neuromodulation therapies for psychiatric and neurological disorders. The company's flagship product, the NeuroStar Advanced Therapy System, uses repetitive transcranial magnetic stimulation (rTMS) to deliver targeted magnetic pulses to areas of the brain implicated in major depressive disorder (MDD). NeuroStar Advanced Therapy has received U.S. Food and Drug Administration clearance for the treatment of adults with treatment-resistant depression and is supported by a growing body of clinical evidence demonstrating its safety and efficacy. Founded in 2003 and headquartered in Malvern, Pennsylvania, Neuronetics focuses on advancing clinical care through innovation in neurostimulation. This instant news alert was generated by narrative science technology and financial data from MarketBeat in order to provide readers with the fastest reporting and unbiased coverage. Please send any questions or comments about this story to [email protected]. The article "Neuronetics Q2 Earnings Call Highlights" was originally published by MarketBeat. 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MALVERN, Pa., July 28, 2026 (GLOBE NEWSWIRE) -- Neuronetics, Inc. (NASDAQ: STIM), a leader in interventional mental health that combines its NeuroStar® TMS technology with direct patient care through the Greenbrook network of interventional psychiatry clinics, today announced that it plans to release second quarter 2026 financial and operating results prior to market open on Tuesday, August 11, 2026. The Company will host a conference call to review its results at 8:30 a.m. Eastern Time the same day. The conference call will be broadcast live in listen-only mode via webcast at https://edge.media-server.com/mmc/p/7ri4xna9. To listen to the conference call on your telephone, participants may register for the call here. While it is not required, it is recommended you join 10 minutes prior to the event start. About Neuronetics Neuronetics, Inc. is a leader in interventional mental health, combining innovative treatment technologies with direct patient care. Through its NeuroStar® Advanced Therapy system, the company is a leading provider of transcranial magnetic stimulation (TMS) treatment and, through Greenbrook, operates one of the largest interventional psychiatry clinic networks in the United States, offering both TMS and SPRAVATO® therapies. NeuroStar Advanced Therapy is a non-drug, noninvasive treatment that can improve the quality of life for people suffering from neurohealth conditions when traditional medication has not helped. NeuroStar Advanced Therapy is the leading TMS treatment for MDD in adults and is backed by what we believe is the largest clinical data set of any TMS treatment system for depression. Greenbrook treatment centers also offer SPRAVATO® (esketamine) Nasal Spray, a prescription medicine indicated for the treatment of treatment-resistant depression (“TRD”) in adults as monotherapy or in conjunction with an oral antidepressant. It is also indicated for depressive symptoms in adults with MDD with acute suicidal ideation or behavior in conjunction with an oral antidepressant.1 The NeuroStar Advanced Therapy System is cleared by the U.S. Food and Drug Administration for adults with MDD, as an adjunct for adults with obsessive-compulsive disorder, to decrease anxiety symptoms in adult patients with MDD that may exhibit comorbid anxiety symptoms (anxious depression), and as a first line adjunct for the treatment of MDD in adolescent patients aged 15-21. For safety information and indications for use, visit NeuroStar.com. Investor Contact:Mike Vallie or Mark KlausnerICR [email protected] Media Contact:[email protected] References 1 The effectiveness of SPRAVATO® in preventing suicide or in reducing suicidal ideation or behavior has not been demonstrated. Use of SPRAVATO® does not preclude the need for hospitalization if clinically warranted, even if patients experience improvement after an initial dose of SPRAVATO®. For more important safety information about SPRAVATO®, please visit spravatohcp.com.

Q1 results: Neuronetics reported revenue of $34.5M (+8% YoY) driven by a 15% rise in Greenbrook clinic revenue (SPRAVATO and buy‑and‑bill) while NeuroStar revenue fell 3% despite shipping 34 systems (+10%); gross margin slipped to 46.9%, net loss narrowed to $10.8M, cash was $19.0M, the company made a $5M debt payment and expects ~$2.5–3M in annualized cost savings. Leadership and strategy: New CEO Dan Reuvers is on a listening tour and is prioritizing broadened go‑to‑market pilots and modernized customer support for NeuroStar, while actively evaluating the potential separation of NeuroStar and Greenbrook to enhance shareholder value. Guidance and catalysts: Management maintained 2026 guidance (total revenue $160–166M, gross margin 47–49%, operating expenses $100–105M) and expects operating cash flow to improve through the year, with upside from expanded TMS access via UnitedHealthcare/Optum policy changes and potential future revenue if Compass Pathways’ psilocybin therapy is approved. Interested in Neuronetics, Inc.? Here are five stocks we like better. Neuronetics (NASDAQ:STIM) reported first-quarter 2026 results that management said were largely in line with expectations, as the company balanced growth in its Greenbrook clinic business with a slight decline in overall NeuroStar revenue. President and CEO Dan Reuvers, who led his first earnings call in the role, also addressed a CFO transition, cost actions, and ongoing evaluation of the company’s structure following shareholder commentary. Reuvers said he joined Neuronetics after roughly 35 years in medtech leadership roles, most recently as CEO of Tactile Medical. Since stepping into the role, he said he has spent the last month on a “listening tour,” including time with the field team, in clinics, and with customers, as well as engagement with shareholders and analysts. → Roblox Stock Slides to New Low as Safety Changes Weigh on Outlook Reuvers highlighted opportunities he sees across both parts of the business. On the NeuroStar side, he said he sees an opportunity to “broaden how we go to market and reach customer segments where we’ve not historically been positioned to compete.” Within Greenbrook clinics, he emphasized workflow and revenue cycle management as key levers to optimize profitability, citing both patient flow and minimizing operational handoffs. Reuvers also noted a CFO transition. He said Steven Pfanstiel “departed earlier this month to pursue an opportunity outside Neuronetics,” and the company has started a search for a successor. → The Real SpaceX Play: 5 Chip Stocks Powering the IPO Before It Launches Reuvers said NeuroStar shipped 34 systems in the quarter, up 10% year-over-year. He also said the company is modernizing customer support through “more virtual, on-demand, and real-time engagement tools” and is piloting an “expanded set of commercial models” intended to broaden NeuroStar’s reach. He said early feedback on those pilots has been positive, with more to share in August. At Greenbrook, Reuvers said clinic revenue grew 15% in the quarter, driven by strength in SPRAVATO and expansion of buy-and-bill. He said TMS volumes in the clinics were “modestly below prior year levels,” which management attributed in part to weather disruptions, particularly in January and February, with better performance in March. → 3 Emerging Markets ETFs to Maximize Exposure to High-Potential Countries During the Q&A, Reuvers told Canaccord Genuity analyst Bill Plovanic that SPRAVATO grew in both buy-and-bill and “A&O” segments, “double-digit in both,” and that buy-and-bill mix has “equilibrate[d] over the last couple of quarters.” He also said marketing spend was “a little lumpy” exiting last year, and that the company is smoothing investment across the year to support consistency. Total revenue for the first quarter was $34.5 million, up 8% from $32.0 million in the prior-year quarter, which management said was primarily driven by higher U.S. clinic revenue. NeuroStar revenue: $12.9 million, down 3% year-over-year. U.S. NeuroStar system revenue: $3.2 million, up 13% year-over-year, with 34 systems shipped. U.S. treatment session revenue: $9.1 million, down 5% year-over-year. Management said utilization increased 3.5% but was offset by lower customer inventory levels. U.S. clinic revenue: $21.5 million, up 15% year-over-year, driven by strong SPRAVATO growth and overall pricing improvement. Gross margin was 46.9% versus 49.2% in the prior-year quarter. Reuvers attributed the decline primarily to revenue mix, with clinic revenues representing a higher portion of total revenue, and to the increased impact of SPRAVATO buy-and-bill compared with the year-ago quarter when the offering was still being launched. Operating expenses were $25.1 million, down 6% from $26.8 million, driven primarily by SG&A efficiencies. Net loss narrowed to $10.8 million, or $0.16 per share, compared with a net loss of $12.7 million, or $0.21 per share, in the prior-year quarter. Adjusted EBITDA improved to negative $6.6 million from negative $8.6 million. As of March 31, total cash was $19.0 million, compared with $34.1 million at December 31. Cash used by operations was $9.4 million, compared with $17.0 million in the first quarter of 2025, which management described as a $7.6 million improvement year-over-year. Reuvers said the company amended its debt agreement with Perceptive Advisors in March 2026 to reduce outstanding debt obligations and interest expense. Under the amendment, Neuronetics made a one-time principal payment of $5 million and adjusted existing debt covenants. Reuvers also said the company took steps to better align its cost structure, with expected annualized savings of approximately $2.5 million to $3 million and net savings beginning in the third quarter. “Profitability and cash are top priorities,” he said. In response to a question about liquidity, Reuvers said the company believes it has “sufficient headroom in the balance sheet to take us through the year,” citing operating cash flow expectations and the company’s full-year burn assumptions. Neuronetics maintained its 2026 guidance, calling for: Total revenue: $160 million to $166 million Gross margin: 47% to 49% Operating expenses: $100 million to $105 million (including about $8.5 million of non-cash stock-based compensation) Cash flow from operations: negative $13 million to negative $17 million Reuvers said operating cash flow is projected to improve beginning in the second quarter and sequentially through the remainder of the year, with operating cash flow “flat to positive” during the second half of the year. For the second quarter, he said the company expects mid-single-digit growth. Reuvers also acknowledged shareholder views suggesting a separation of the NeuroStar and Greenbrook businesses could unlock value. He said he is evaluating the business “with an open mind” and emphasized that the board and management are focused on disciplined decision-making that creates long-term shareholder value. In the Q&A, Reuvers said he believes the company has “underpunched our weight” recently in NeuroStar and described expanding the “go-to-market menu” as a potential catalyst. He also discussed the balance between driving utilization and expanding the installed base, saying both are important and that the company wants to ensure NeuroStar units are placed in clinics “regardless…of what economic model is in place.” Reuvers also pointed to potential longer-term opportunity from Compass Pathways’ pending psilocybin therapy, noting that the regulatory process is Compass’s to navigate and that the Trump administration’s recent executive order prioritizing such submissions was “encouraging.” If approved, he said Greenbrook is “among a very small number of providers genuinely equipped to deliver it,” though he cautioned that, similar to SPRAVATO, the revenue ramp would likely be “measured in the first year of launch.” Additionally, Reuvers referenced UnitedHealthcare and Optum’s coverage policy change allowing nurse practitioners to deliver TMS, saying it could expand the company’s target list by enabling the company to revisit clinics where TMS “wasn’t a viable option” under prior reimbursement limitations. He noted the change affects 35 million covered lives across 26 states and said it is still early in the rollout. Neuronetics, Inc is a commercial‐stage medical technology company that develops and markets non-invasive neuromodulation therapies for psychiatric and neurological disorders. The company's flagship product, the NeuroStar Advanced Therapy System, uses repetitive transcranial magnetic stimulation (rTMS) to deliver targeted magnetic pulses to areas of the brain implicated in major depressive disorder (MDD). NeuroStar Advanced Therapy has received U.S. Food and Drug Administration clearance for the treatment of adults with treatment-resistant depression and is supported by a growing body of clinical evidence demonstrating its safety and efficacy. Founded in 2003 and headquartered in Malvern, Pennsylvania, Neuronetics focuses on advancing clinical care through innovation in neurostimulation. The article "Neuronetics Q1 Earnings Call Highlights" was originally published by MarketBeat.

Image source: The Motley Fool. Tuesday, May 5, 2026 at 8:30 a.m. ET President and Chief Executive Officer — Daniel Reuvers [Interim Moderator] — Mark Klausner Operator: Good day, and thank you for standing by. Welcome to the Neuronetics First Quarter 2026 Financial and Operating Results Call. [Operator Instructions] Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today. Mark Klausner: Good morning, and thank you for joining us for the Neuronetics First Quarter 2026 Conference Call. Joining me on today's call is Neuronetics' President and Chief Executive Officer, Dan Reuvers. Before we begin, I would like to caution listeners that certain information discussed by management during this conference call will include forward-looking statements covered under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, including statements related to our business, strategy, financial and revenue guidance and other operational issues and metrics. Actual results can differ materially from those stated or implied by these forward-looking statements due to risks and uncertainties associated with the company's business. For a discussion of risks and uncertainties associated with Neuronetics' business, I encourage you to review the company's filings with the Securities and Exchange Commission, including the company's annual report on Form 10-K, which was filed in March and the company's quarterly report on Form 10-Q for the quarter ended March 31, 2026. The company disclaims any obligation to update any forward-looking statements made during the course of this call, except as required by law. During the call, we'll also discuss certain information on a non-GAAP basis, including EBITDA and adjusted EBITDA. Management believes that non-GAAP financial information taken in conjunction with U.S. GAAP financial measures provides useful information for both management and investors by excluding certain noncash and other expenses that are not indicative of trends in our operating results. Reconciliations between U.S. GAAP and non-GAAP results are presented in the tables accompanying our press release, which can be viewed on our website. With that, it's my pleasure to turn the call over to Neuronetics' President and Chief Executive Officer, Dan Reuvers. Daniel Reuvers: Thanks, Mark, and welcome, everyone, to our first quarter 2026 earnings call. I'll begin by sharing some perspectives on my background and why I joined the company, discuss some early observations, and then I'll walk through the key drivers of our performance in the quarter. Then I'll walk through our quarterly financial results in greater detail, and I'll conclude with my perspective on the rest of 2026 before opening the line for questions. This is my first earnings call as CEO of Neuronetics, and I'm pleased to be here. I've spent about 35 years in the med tech industry, and most of my career has been in businesses where patient impact, execution and operational rigor drive the outcome. Most recently, I served as CEO of Tactile Medical, where we grew revenue from $187 million to approximately $300 million. During that time, we expanded patient reach, grew gross margins, delivered record earnings and cash flow generation. Before that, I spent 12 years with Integra LifeScience, where I led the $1 billion Codman Neurosurgery division. And earlier in my career, I held leadership roles at several other med tech companies. There were a couple of things that drew me to this role. First, our mission to renew lives by restoring hope for patients and their families is one that I'm passionate about. It's amazing how many people have reached out to me since taking the role, sharing their stories of how they or someone they knew have either suffered from depression or better yet benefited from one of our therapies. Second, I think my background gives me a great perspective on how to move this business forward. My experience in the device space will allow me to come up to speed on the NeuroStar business quickly. And it's notable that Tactile was vertically integrated, meaning we designed, manufactured and sold our therapy solutions, but also directly build third-party payers, an experience I expect to draw on as we continue to improve efficiency within our Greenbrook clinics. Since stepping into the role, I've spent the bulk of the last month on a listening tour. I've been on the road with our field team, inside our clinics and meeting with customers. I've also engaged with shareholders, analysts and others, helping me shape my understanding of the business. My approach has been deliberate and comprehensive, intended to allow me to fully understand this business before making decisions about where to lean in, where to adjust and how we maximize the value of what we have. With that said, what I've seen in my first few weeks has reinforced my conviction in the underlying opportunity that exists for us. First, on the NeuroStar side, I see a clear opportunity to broaden how we go to market and reach customer segments where we've not historically been positioned to compete. I'll talk more about that in a moment. Second, with the Greenbrook clinics, workflows are key to optimizing profitability in our clinics, not only ensuring that patients have an efficient path to initiate their treatment and gain relief, but also to minimize operational handoffs. Revenue cycle management is also an area where I've spent time in my previous role. And what I've seen inside our clinic operations tells me there is more opportunity ahead. Lastly, we have a talented team that's focused and executing. And I've been genuinely impressed with the quality of the people and the conviction toward our mission across the organization. Now before I walk through the quarter, I'd like to briefly address 2 items. First, on our recently announced CFO transition. Steve Fansteel departed earlier this month to pursue an opportunity outside Neuronetics. We've initiated a comprehensive search to identify his successor. We appreciate Steve's contributions during his time at Neuronetics, and we'll provide updates as the search progresses. Ultimately, this allows me to select a partner that I'm confident, can help me lead our next chapter. Second, I want to share some perspective on the comments made by certain shareholders about our business. While we believe that the integrated NeuroStar and Greenbrook businesses provide us with a strong foundation to grow from, we respect some shareholders' views that the separation of the business could potentially unlock shareholder value. The Board and I are aligned on operating this business with discipline and on making decisions that create long-term value for our shareholders. I assure you that I'm evaluating this business with an open mind, and I appreciate everyone's patience as I work through my process. With that context, let me share a bit more about our performance in the quarter. Our Q1 results were largely in line with expectations, and we're making progress on the commercial and operational priorities already in motion. Starting with the NeuroStar business. During the quarter, we shipped 34 systems, up 10% year-over-year. We continue to support our installed base with the most comprehensive training and clinical resources in the category. We're also modernizing how we deliver that support with more virtual, on-demand and real-time engagement tools that provide customers with choices on how they want to be supported. We're piloting an expanded set of commercial models for NeuroStar. Customers exist with a range of needs. And while we have a history of providing unparalleled ongoing support to our customers, we also know that not all customer's needs are the same. So expanding our go-to-market menu is a priority. I'm convinced that we can compete on a broader horizon by listening to customers and responding in kind. Early feedback has been positive, and I'll have more to share in August. Now a few comments on Greenbrook. Clinic revenue grew 15% in the quarter. Growth in the quarter was driven by continued strength in SPRAVATO with treatment growth year-over-year and expansion of buy-and-bill. On the TMS side, within our clinics, volumes were modestly below prior year levels in the quarter, which we attribute in part to weather disruption across portions of our footprint during the first 2 months of the quarter. We saw patient flow normalize as the quarter progressed, and we expect to return to more typical volume trends as we move into the second quarter. Within our clinic operations more broadly, the focus remains on workflow and revenue cycle management. The team has made real progress on collections and operational efficiency, and we see continued runway. We've also leveled our marketing investment across the year rather than front-loading it, which we believe is the right cadence for the business. We acted during the quarter to better align our cost structure. These steps are expected to deliver annualized savings of approximately $2.5 million to $3 million with net savings beginning in the third quarter. Profitability and cash are top priorities and will be a focus of mine going forward. Taken together, the quarter reflects a business that's executing on the priorities already in motion while we lay the groundwork for our next phase of growth. With that, I'll walk through the financial results in greater detail. Unless otherwise noted, all performance comparisons are being made to the first quarter of 2026 versus the first quarter of 2025. Total revenue in the first quarter was $34.5 million, an increase of 8% compared to revenue of $32 million in the first quarter of 2025. The increase in revenue was primarily driven by higher U.S. clinic revenue. Total revenue from our NeuroStar business, inclusive of our system revenue as well as treatment session revenue was $12.9 million in the first quarter of 2026. This represents a decrease of 3% versus the prior year. U.S. NeuroStar system revenue was $3.2 million, an increase of 13% on a year-over-year basis, and we shipped 34 systems in the quarter, an increase of approximately 10% versus the prior year. U.S. treatment session revenue was $9.1 million, a decrease of 5%, while system treatment utilization increased 3.5%. This was offset primarily by a reduction in customer inventory levels. U.S. clinic revenue was $21.5 million, a 15% increase year-over-year. The results were driven by continued strong SPRAVATO growth and overall pricing improvement. Gross margin was 46.9% in the first quarter of 2026 compared to 49.2% in the prior year quarter. The decrease in gross margin is a result of revenue mix with clinic revenues representing a higher portion of our overall revenues. We also saw some negative impact from the increase in SPRAVATO buy-and-bill from Q1 of last year when we were still launching that offering. Operating expenses during the quarter were $25.1 million, a decrease of $1.6 million or approximately 6% compared to $26.8 million in the first quarter of 2025. The decrease is primarily attributable to savings in SG&A expenses, where we have driven and will continue to drive efficiencies. Net loss for the quarter was $10.8 million or $0.16 per share as compared to a net loss of $12.7 million or $0.21 per share in the prior year. First quarter 2026 adjusted EBITDA was negative $6.6 million as compared to negative $8.6 million in the prior year, an improvement of $2 million. Moving to the balance sheet and cash flow. As of March 31, total cash was $19 million, consisting of cash and cash equivalents and restricted cash as compared to $34.1 million as of December 31. Cash used by operations in the first quarter was $9.4 million. This compares to an operating cash use of $17 million in Q1 of 2025, an improvement of $7.6 million versus the prior Q1. As previously disclosed, in March 2026, we amended our debt agreement with Perceptive Advisors, which reduces our outstanding debt obligation and interest expense. Under the amendment, we made a one-time principal payment of $5 million to Perceptive Advisors, along with adjustments to the existing debt covenants. Now turning to guidance, which remains unchanged. We continue to expect total revenue between $160 million and $166 million, gross margins to be between 47% and 49%, operating expenses in the range of $100 million to $105 million, inclusive of approximately $8.5 million of noncash stock-based compensation. Cash flow from operations between negative $13 million and negative $17 million. As a reminder, our operating cash flow is projected to improve beginning in the second quarter and then sequentially through the remainder of the year, with operating cash flow being flat to positive during the second half of the year. And in the second quarter, we expect to see mid-single-digit growth. As we look ahead to the remainder of 2026, our priorities are clear. We're focused on disciplined execution, sharpening how we go to market and continuing to drive the business towards being cash flow positive. The pilots we have underway in the NeuroStar side of the business are designed to expand our reach and within our clinic operations, we'll continue to focus on workflow, collections and operational efficiency. We expect these benefits to continue building throughout the year. Looking further out, I want to briefly touch on COMPASS Pathways pending psilocybin therapy. The regulatory process is Compasses to navigate, but the Trump administration's recent executive order prioritizing such submissions is certainly encouraging. If approved, we believe Greenbrook is among a very small number of providers genuinely equipped to deliver it. The protocol requires certified settings, trained clinical staff and a proven back-office infrastructure for benefits investigation and prior authorization, all of which we already have in place through our SPRAVATO operations. While we will be prepared to execute if the product is approved, similar to SPRAVATO, we'd expect the revenue ramp to be measured in the first year of launch, but the narrow pool of providers capable of delivering this therapy represents a durable advantage for our business. As I mentioned earlier, my approach in these first few weeks has been deliberate. I'm committed to making decisions that balance the interest of our patients, physicians, colleagues and shareholders. And I expect to be able to share an even more grounded view of where we're headed when we report next quarter. I want to thank the Neuronetics team for the work they've put in this quarter and for the welcome they've given me. I look forward to updating you all on our progress in August. And with that, I'll open the call for questions. Operator? Operator: [Operator Instructions] Our first question comes from the line of Bill Plovanic from Canaccord Genuity. William Plovanic: So 3 questions for you, Dan, if I could. One is just clarity on the performance in the Greenbrook sites. I just want to make sure I heard that the -- was it the treatment revenue and number of treatments was down year-over-year, backing out the SPRAVATO. I just want to get -- to make sure I heard that correctly. Daniel Reuvers: Yes. Overall, we were pleased with the Greenbrook performance. We were up double digits, as we said, about 15%. The TMS volumes were off a little bit, Bill. And we think that, that was related to a couple of things. One, weather, which we -- pretty concentration up here in the Northeast. And then we were a little lumpy in our ad spend as we exited last year. So smoothing that this year, I think, is going to bring that more in line with consistency. But we also saw better performance in March than we did in January and February. So it was -- we don't think that, that was a trend as much as an event. On the SPRAVATO side, we saw growth in both the buy-and-bill and the A&O segments, double digit in both segments. And yes, buy-and-bill was up as a mix compared to Q1 of last year. But I think it's worth noting that we've also seen that kind of equilibrate over the last couple of quarters as far as mix between that and A&O. William Plovanic: Okay. Great. And then just secondly, one of the biggest challenges new executives face when they come into a company is just making sure to keep the team intact and turnover. And I just wanted to see if you could provide any color on what you've seen thus far. I know it's only been 45 days, but just kind of what you're seeing across the organization thus far. Daniel Reuvers: Yes. It's -- first of all, I've been really impressed with how much the mission permeates through the company. People are really connected with the impact that we're making on patient's lives. I mentioned in my opening comments that I was on -- I've been on a listening tour for the first month for the most part. And that gave me an opportunity to go out and spend time with folks in the field as well as having spent a good amount of time in the office. So I've met with a lot of people, have been trying to connect as best I can with things like podcasts and town halls. And so far, I've been pleased with, as I said, kind of where people's attitudes are. I think there's an anxious enthusiasm to think about how we might do things different, how we might continue to find ways to get better. So overall, I would say, quite good. And I don't -- I haven't seen anything as far as turnover spikes or anything that would have, I would say, raised an eyebrow for me. William Plovanic: Okay. I think just the last question is really elephant in the room. I mean you addressed it, but I just wanted to hit home on it. Just you ended the quarter with $19 million of cash, $13 million unrestricted. It sounds like given the guidance that would tell us you'll use $4 million to $8 million of that during the full year. I would expect most of that would be in the second quarter given the guidance that the back half would be positive. I just -- any thoughts, comments? Is that enough to get you through with working capital? And just how are you thinking about that today? Daniel Reuvers: Yes. I mean we're always evaluating the balance sheet. But I think as we shared at the midpoint of $15 million of burn for the full year, the math would lead you to $14 million at year end. So -- and you're also right in that our assumptions are that we would be flat to positive in the second half of the year. So based on the current plan, we feel like we've got sufficient headroom in the balance sheet to get us -- to take us through the year. Operator: Our next question comes from Adam Maeder of Piper Sandler. Adam Maeder: Congrats on the new role and look forward to working with you again. Two for me, one kind of housekeeping question and one bigger picture question. Just on the housekeeping item, weather. It sounded like there was an impact to TMS volumes at Greenbrook clinics. I was hoping you could kind of quantify that for us. Is it also reasonable to assume that your stand-alone NeuroStar business also saw some headwind from weather? And how do we think about how quickly these patients can potentially kind of be -- their sessions can be recaptured? And then I had a follow-up. Daniel Reuvers: Yes. I'm not going to quantify on the Greenbrook side, Adam, but we did see -- we do think that there was some of the impact there, particularly because we saw more of the weakness in January and February than we did in March. It's also worth noting on the NeuroStar side that TMS patients are coming in every single day. So trying to manage a schedule around weather is more difficult than SPRAVATO patients that are coming in more episodically and have a lot more latitude in scheduling. So I think that was one of the reasons that we saw the impact within Greenbrook. On the NeuroStar side, we think that we saw some of the same kind of impact from weather. But that said, from a total utilization standpoint, we were actually up low single digits on absolute utilization within our NeuroStar business as far as treatment sessions were concerned. We saw a little softness in the revenue [ rec ] just because we had a little bit of customer inventory on hand that folks are working through. But overall, I would say the business held up quite well in spite of the weather. Adam Maeder: Okay. Fantastic. And then for my follow-up, Dan, in the press release, you talked about significant value in the business that's yet to be fully realized. You also have a large shareholder who issued a letter last month for -- asking for a strategic review and potentially a sale of the TMS business. And you touched on it in the prepared remarks. I think I heard you're evaluating the business with an open mind. I guess I was hoping you could share a little bit more color here on your early learnings and thoughts as you think about kind of the broader makeup of Neuronetics. And one question that I sometimes get from investors is the NeuroStar business, the stand-alone business, why can't that business grow faster given the size of the total addressable market? And what are the plans to kind of catalyze that business? And sorry for the multipart question. Daniel Reuvers: Yes. Yes, no problem. So first, as it relates to the shareholder letter that we saw. As I said in my opening remarks, I mean, I really have been on a listening tour, and I've had outreach to that shareholder along with others just to make sure that I'm hearing some of their thoughts and concerns. I think there's some frustration there. And quite frankly, I appreciate it. I think that what I'm still trying to do is really look at the business through a variety of different lenses, and I'm pretty pragmatic about it. I mean I'm not wed to a predetermined conclusion, but I'm also not inclined to be impetuous and make sure that I look at the business overall. I think as it relates to what can we do to continue to demonstrate strength and growth, which under any outcome scenario adds long-term value for shareholders, it's looking at the NeuroStar business, I do think that we probably under punched our weight here lately. The opportunity to expand our go-to-market menu is one of the things that I believe is going to be a helpful catalyst for us. And we're still in pilot phases on that, Adam. But ultimately, we have taken an approach that has conveyed what I would call unparalleled support to our TMS customers. I don't think any other competitor out there comes even close to the kind of support we provide to our customers. But that said, not all customer's needs are the same. So I think it's important for us to expand our menu and allow customers to kind of establish which parts of value they want and make sure that we've got kind of a broader girth of go-to-market menus that they can select from. So we're in the midst of doing some pilots right now. I think we'll have a lot more clarity over the next couple of months, but it includes making sure that we're looking at incentive comp that it's aligned with our direction, that we have an opportunity to revisit our funnel and make sure that we've slotted those in the right spaces. So more work to do, but I think that as we continue to really reevaluate our go-to-market and with an open mind look at how we can make sure that we're matching the right level of support to that, which the customer wants to pay for. I think that's a ratio that I expect will bear some fruit. Operator: Our final question comes from the line of Danny Stauder of Citizens JMP. Daniel Stauder: Just my first one, following up on kind of the TMS question. But Dan, I wanted to ask about the commercial strategy for TMS. We know there was a realignment of the capital sales team and system sales have been strong the last 2 quarters. But as you sit here in the early days of your tenure, just broadly, how do you think about the balance between focusing on driving utilization per site versus expanding the installed base? Are there any potential strategic changes here? Or how do you think about that balance? Daniel Reuvers: I think continuing to drive utilization is an important one because whether we're on a sessions model or otherwise, it's what's the underlying creation of demand and the more utilization our customers continue to find more patients they can help. One way or another, that's going to lead to an expansion of our business. So I think we're going to continue to look to how we can expand our socket placement or placement of new capital units. I think that's one of the places where we've probably slipped a bit and focusing on new placements and expansion of capital and making sure that it's our unit that resides in those clinics. Whether regardless, I guess, of what economic model is in place, we just want to make sure that we're demonstrating the most value across the competitive landscape. And I think that between the support we provide with our account managers in the field with benefits investigation, our co-marketing, training, service, the cloud-based TrakStar utility that we've got, I just don't think anybody can compare there. And we're going to, as I said, continue to work through a couple of pilots. But the things that got us there, I think, will continue to be durable areas of value and how we structure that, I think, is some of the things that we're still titrating a bit. Daniel Stauder: Great. Appreciate that. And then just one on the Compass collaboration. Obviously, the recent update from the administration is good news. But I just want to get a sense of how meaningful this could be? Obviously, Compass is already pretty far along in terms of the approval process, but do you feel this recent update could be more important on the reimbursement pathways? I know that's been a focal point for eventual contribution. So just any thoughts you have there would be appreciated. Daniel Reuvers: Yes. Well, first of all, I think that the whole Compass opportunity and psychedelics at large represent a big opportunity for us given our footprint and our infrastructure. I was really excited in my first month to see the Trump executive order leaning into the FDA process on some of these. So I think that it probably adds or it shortens the fuse. How much? I don't know, but it probably shortens the fuse on the path to approval, which I think is encouraging for all of us that are in this space. I'm not sure how much it impacts reimbursement. I think that's probably a separate track, but certainly, the pursuit of that in tandem on Compass' behalf, all of those things sort of point to faster than slower. And as we get into 2027, we'll certainly look forward to being able to try and better quantify what we think that means to us. I think if you look at the SPRAVATO rollout from the early days, as much enthusiasm as there was, it's a bit measured in its early adoption. But I think that the momentum is certainly moving in the right direction on this one. Daniel Stauder: Great. I appreciate that. And just one last one for me. I just wanted to ask on some of the TMS coverage expansion to include nurse practitioners. I was just curious, high level, if there have been any incremental conversations with accounts on this topic? Have you seen that customers are waiting for this, maybe somewhat higher demand? Just anything more on how this could impact utilization and how you think it will play out in '26 and beyond, would be great. Daniel Reuvers: Yes. So that's the reference to the UHC and the Optum coverage policy change where nurse practice can now be eligible to deliver TMS versus licensed psychiatrists. I think it's a good move. We've got a lot of really quality nurse caregivers out there. I don't know that they were waiting for it as much because maybe they didn't -- sometimes you never know if it's ever coming, but there are 35 million covered lives in the 26 states that will be affected. And I think what it will allow us to do or has allowed us to do is go revisit some of those clinics that are managed by nurse practs where TMS just wasn't a viable option because of the reimbursement limitations. So I think it probably added a number of accounts to our target list, but still early days since we're, I think, a month in. Operator: This concludes the question-and-answer session. I would now like to turn it back to Dan Reuvers for closing remarks. Daniel Reuvers: Yes. I just wanted to thank all of our employees for a hard-fought quarter as they all are as we continue to try and restore hope to patients and their families. And I wanted to thank our shareholders for their support, and I look forward to sharing an update on our progress when we have an opportunity to share the results of our second quarter. Thank you. Operator: Thank you for your participation in today's conference. This does conclude the program. You may now disconnect. Before you buy stock in Neuronetics, consider this: The Motley Fool Stock Advisor analyst team just identified what they believe are the 10 best stocks for investors to buy now… and Neuronetics wasn’t one of them. The 10 stocks that made the cut could produce monster returns in the coming years. 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As with all our articles, The Motley Fool does not assume any responsibility for your use of this content, and we strongly encourage you to do your own research, including listening to the call yourself and reading the company's SEC filings. Please see our Terms and Conditions for additional details, including our Obligatory Capitalized Disclaimers of Liability. The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy. Neuronetics (STIM) Q1 2026 Earnings Transcript was originally published by The Motley Fool

New CEO Dan Reuvers is conducting a comprehensive 'listening tour' to evaluate the integrated NeuroStar and Greenbrook business model following shareholder calls for a strategic separation. Q1 revenue growth of 8% was primarily driven by a 15% increase in U.S. clinic revenue, specifically fueled by continued strength in SPRAVATO treatment volumes and 'buy-and-bill' expansion. NeuroStar system shipments increased 10% year-over-year to 34 units, though treatment session revenue declined 5% due to a reduction in customer inventory levels. TMS volumes within Greenbrook clinics were modestly below prior-year levels, which management attributed to weather disruptions in the Northeast and a shift in the cadence of marketing spend. Management is piloting expanded commercial models for NeuroStar to reach customer segments that require different levels of support than the company's historically comprehensive service model. Gross margin compression to 46.9% was driven by revenue mix, as lower-margin clinic revenues represented a larger portion of total sales compared to the prior year. Full-year 2026 revenue guidance is maintained at $160 million to $166 million, with operating cash flow expected to be flat to positive in the second half of the year. The company implemented cost-alignment steps in Q1 expected to deliver annualized savings of $2.5 million to $3 million, with net savings beginning in the third quarter. Management expects to return to typical TMS volume trends in the second quarter as patient flow normalized following early-quarter weather disruptions. The company is positioning Greenbrook as a primary delivery site for pending psilocybin therapies, leveraging existing SPRAVATO infrastructure for certified settings and back-office support. A comprehensive search is underway for a new CFO following the departure of Steve Fansteel, with the CEO seeking a partner to lead the company's next growth chapter. The company amended its debt agreement with Perceptive Advisors in March 2026, making a one-time $5 million principal payment to reduce outstanding obligations and interest expense. Cash and cash equivalents declined to $19 million as of March 31, though management believes current liquidity is sufficient to reach the goal of second-half cash flow positivity. Recent UHC and Optum policy changes allowing nurse practitioners to deliver TMS are expected to expand the target account list in 26 states where reimbursement was previously limited. Management acknowledged shareholder frustration regarding valuation and stated they are evaluating the business with an 'open mind' regarding potential structural changes. Our analysts just identified a stock with the potential to be the next Nvidia. Tell us how you invest and we'll show you why it's our #1 pick. Tap here. Management projects a full-year cash burn midpoint of $15 million, which would leave approximately $14 million in cash at year-end. The plan assumes the business becomes flat to cash flow positive in the second half of the year, providing sufficient headroom under current debt covenants. CEO Reuvers is pragmatically evaluating whether the integrated model or a separation of the TMS business unlocks more value, noting he is not wed to a predetermined conclusion. He emphasized that improving NeuroStar's 'go-to-market menu' is a priority to ensure the company is not 'under punching its weight' in the total addressable market. While absolute treatment utilization was up low single digits, revenue was impacted by customers working through existing inventory. TMS patients require daily visits, making the business more sensitive to weather disruptions than episodic therapies like SPRAVATO. One stock. Nvidia-level potential. 30M+ investors trust Moby to find it first. Get the pick. Tap here.